Comparison of myringoplasty techniques for eardrum perforations

Abstract

Purpose

This retrospective study aims to analyze and compare the surgical outcomes and efficacy of different myringoplasty techniques, specifically focusing on Gelfoam-stuffed graft, Gelfoam overlay graft, and fat graft. The objective is to provide insights into the success rates and associated factors for each method in pediatric patients undergoing myringoplasty.

Materials and methods

The study included patients under 18 years who underwent myringoplasty between 2014 and 2022. Data was collected on patient demographics, perforation size and location, etiology, age at myringoplasty, technique used, operative time, and postoperative outcomes.

Results

Out of 561 myringoplasties, 325 met study criteria with an average age of 7 years. Gelfoam overlay (39 %), Gelfoam-stuffed (51 %), and fat graft (10 %) were the techniques analyzed. Overall, 96.3 % of cases were successful, with no significant differences among the three techniques. Postoperatively, 17.7 % had perforation, 13.8 % had otorrhea, and 2.1 % required additional surgery. Fat grafts associated with significantly longer operative times and were more likely to be done for persistent perforations rather than retained ear tubes.

Conclusion

This study demonstrates comparable efficacy among Gelfoam-stuffed graft, Gelfoam overlay graft, and fat graft myringoplasty techniques in pediatric patients. While surgical time differed, there were no clinically significant variations in postoperative outcomes. Despite limitations, these findings suggest that all three techniques are viable options, allowing otolaryngologists flexibility in choosing myringoplasty methods based on patient characteristics and clinical considerations.